LGBTQ_Applicant_Data_Form_B2627194.pdf
PDF 2 MB Posted
- Attached to
- Arts & Crafts Supplies
- Solicitation number
- B2627194
- Issued by
- Pennsylvania
About this file
This is an LGBTQ Applicant Data Form issued by the City of Philadelphia's Procurement Department in connection with bid or contracting opportunity B2627194. The form is designed to collect voluntary information from applicants regarding their business ownership and certifications related to Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) individuals. The form requests applicants to identify whether their business is beneficially owned and controlled by persons who self-identify as LGBTQ, and to provide information about current LGBTQ Business Enterprise (LGBTBE) certification status through the National LGBT Chamber of Commerce (NGLCC) or its Philadelphia affiliate, the Independence Business Alliance (IBA). The form also inquires whether applicants hold certifications from other third-party agencies such as the Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN, or Women's Business Enterprise National Council (WBENC).
The form additionally requests identification of any LGBTBE-certified subcontractors being utilized for the contracting opportunity. The City of Philadelphia indicates that the data collected is intended to identify LGBTQ-owned businesses currently or seeking to do business with the City and will be used to enhance inclusion efforts within the City's vendor database. Responses are entirely voluntary, and applicants acknowledge that submitted data may be used for other projects and may become publicly available at the City's discretion. The form is part of the City's broader commitment to diversity, equity, and inclusion in municipal procurement activities.
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Other files
| File | Type | Posted |
|---|---|---|
| Consent_Authorization_B2627194.pdf | ||
| MP_Terms_and_Conditions_B2627194.pdf | ||
| Seller_SOP_Checklist_B2627194.pdf |
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Text version
1. Is Applicant’s business beneficially owned and controlled by persons who self-identify as Lesbian, Gay, Bisexual, Transgender or Queer?
2. Is Applicant’s business currently certified as a Lesbian, Gay, Bisexual, Transgender, Business Enterprise (LGBTBE) by the National LGBT Chamber of Commerce (NGLCC) through their local Philadelphia affiliate, the Independence Business Alliance (IBA)?
a. If yes, Applicant is currently certified by NGLCC/IBA as an LGBTBE, is Applicant's business also certified by any other third party certifying agency such as Eastern Minority Supplier Development Council (ESMDC), Pennsylvania Unified Certification Program (PAUCP), Disability:IN or Women's Business Enterprise National Council (WBENC)?
If yes please identify the name of the certifying agency and category of certification (e.g., MBE, WBE, DSBE, DBE):
Certifying Agency:
Certification Category:
3. For this contracting opportunity, are any of Applicant's subcontractors certified by NGLCC/IBA? If yes, how many subcontractors are certified as LGBTBE?
Please list all by business name below.
As part of the City of Philadelphia’s commitment to diversity, equity and inclusion in all aspects of City procurement, the City is collecting data to identify the number of companies beneficially owned and controlled by Lesbian, Gay, Bisexual, Transgender and Queer persons who wish to do business with the City (collectively, “LGBTQ businesses”). The data will be used to identify the number of LGBTQ businesses currently doing business with the City. It will also assist in efforts to include LGBTQ certified businesses into the City’s vendor database.
By submitting this form you are agreeing that the City may, in its discretion, use the data submitted for other projects and may cause it to become publicly available.
Response to this form is entirely voluntary.
Applicant Name:
Bid or Opportunity #:
LGBTQ Applicant Opportunity DataLGBTQ Applicant Opportunity Data
CCIITTY Y OF OF PHIPHILALADDELPHELPHIIA
1401 JFJFK K BBllvvdd. . RoRooom m 117700B B - - PhPhiillaaddeellpphhiiaa, , PA PA 1199110022--11668855 www.phila.gov/procurement
| CertifiedLGBTEYes: Y |
| CertifiedLGBTENo: N |
| Certification: |
| LGBTQTypeYes: Y |
| LGBTQTypeNo: N |
| CertifiedNGLCCNo: N |
| CertifiedNGLCCYes: Y |
| LGBTQTypeY: Off |
| LGBTQTypeN: Off |
| CertifiedLGBTEY: Off |
| CertifiedLGBTEN: Off |
| CertifiedNGLCCY: Off |
| CertifiedNGLCCN: Off |
| Subconsultants: |
| BusinessName3: |
| BusinessName4: |
| BusinessName5: |
| Reset: |
| btnContinue: |
| CertifyingAgency: |
| BusinessName: |
| BusinessName2: |
| ApplicantName: |
| BidNumber: |
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